Clinical engineers should be a part of medical equipment dept

Dr Narendranath V

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A study conducted in district hospital near New Delhi in early 90s about availability and utilization of equipment showed the following results. There was short fall of 25.9 per cent requirement for equipment compared to standard requirements. The actual utilization of available equipment was found to be only 39.3 per cent. The rest were non functional – 35.5 per cent or not in use 25.2 per cent. Most of non functional equipment were lying for condemnation (28.2 per cent) and only 73 per cent kept for repair.

The reasons for low availability, non functioning and under utilization were found to be improper and poor system of maintenance and repairs, and tendency to keep some of them in reserve for their future use in care of breakdown of existing ones.

This is the existing scenario in the most of major hospitals in the country notwithstanding that availability and utilization of various equipment at all levels of health system for effective and efficient service delivery was amply emphasized in the Alma-Ata declaration at International conference on primary health care in 1978, which was late included into strategy paper of health for all by 2000 AD. The planning commission of India in their 8th plan document has also emphasized the role of essential equipment in the delivery for health and family welfare services.

Strategy for maintainence

The management of biomedical equipment for optimal and safe use requires a multi-dimensional systems approach. Equipment management should start with a proper purchasing strategy followed with regular preventive maintenance, occasional repairs, and finally, should conclude with appropriate retirement of the equipment. The best management approach will strive to maximize the usage of the equipment time by more than one hospital or clinic, if at all possible. These objectives can be accomplished by developing a proper maintenance and servicing model of biomedical equipment as follows:

Database:

To determine the nature and magnitude of the problem it is necessary to have detailed database of the biomedical equipment available in Indian hospitals. Detailed information and history of about each piece of equipment should be collected from the hospitals or institutes.

Every minute detail such as cost, benefits, foreign exchange component, supplier, suitable action plan, date of installation etc. should be incorporated in the data bank of individual equipment.